Fear. Uncertainty. Doubt. The persuasive health care industry strategy for sowing unease about industry reform was on display at Tuesday’s first-ever congressional hearing on the Medicare for All Act of 2019, but health insurers’ allies were overshadowed by the dramatic testimony of a prominent reform advocate.
As a former purveyor of FUD in my job as head of corporate communications for a large for-profit insurance company, I protected the status quo by convincing both members of Congress and health insurance industry witnesses to dwell on “disruption” to the existing health care system. I helped mislead the public about the cost of Medicare for All. And it worked.
But those tactics from my old job were nowhere near as effective as I’m sure the industry hoped they would be during Tuesday’s hearing. It went much better than advocates expected, especially considering that Speaker Nancy Pelosi and other House leaders have said Democrats’ priority should be to strengthen the Affordable Care Act rather than try to rebuild our notoriously unfair and expensive health care system.
- Notably, Pelosi was seen escorting star witness Ady Barkan, who has ALS and whose testimony was riveting, to the hearing room. Barkan was not among those originally scheduled to testify. He was added after reaching out to Pelosi and asking to speak on behalf of Rep. Pramila Jayapal’s proposed legislation.
- Republicans did not bring their A game to the hearing. Charles Blahous of the Mercatus Institute, founded and largely funded by the Koch Family Foundations, acknowledged that even though Medicare for All would require an increase in federal funding, much of it would come from shifting money people currently pay in private insurance company premiums to a pool that would be administered by the Center for Medicare and Medicaid Services. And Grace-Marie Turner of the Galen Institute, which also gets much of its money from conservative foundations and groups affiliated with big health care companies, essentially recycled what she has been writing and saying since she founded the Institute in 1995–that Americans don’t want a “government-run” system, that a free market is the cure.
- The Republicans and their witnesses did indeed try to paint a grim and scary picture of the “disruption”Medicare for All would create, especially to those who have coverage through their employers. They of course didn’t mention the constant disruption caused by today’s system as insurers and employers drop people from coverage and shift the cost of care to patients by making them pay thousands of dollars out of their own pockets before coverage kicks in. And then there is the little problem they never mention: millions of people become uninsured every year when they lose or change jobs.
- GOP Rep. Tom Cole of Oklahoma warned of rural hospital closings under a Medicare for All system. He needs to get out more. At least six rural hospitals in Oklahoma have closed in recent years, and twice that many have closed in my home state of Tennessee. Among the reasons: the rising number of people who are either uninsured or underinsured and can’t pay for the care they get in hospitals.
- Turner and other industry allies contended that Americans don’t support Medicare for All by citing as evidence the failure of t Vermont and Colorado to implement state-based single payer programs. What they didn’t note was that the insurance industry and allied groups spent millions of dollars on FUD campaigns to turn public sentiment against those states’ proposals.
- As Vox noted in its coverage of the hearing, Sara Collins of the Commonwealth Fund “undercut” one of opponents’ arguments against Medicare for All, that hospitals and doctors need the higher payments they get from private insurers to stay in business. “The evidence really does not show that the reason that private provider prices are higher is because Medicare rates are so low,” she said. She went on to explain, as I’ve often noted, that private insurers don’t–and can’t–control health care costs, especially hospital costs. “In concentrated markets,” Collins told the committee, “they [hospitals] get higher prices, and insurers want them in their network. So they concede to those higher prices. They then take that negotiated rate to employers. Employers have to pay higher premiums. They reduce their workers’ wages, they increase their deductibles, and those costs get ultimately shifted to people.”
I will continue to comment on this political battle as it unfolds and provide an antidote to FUD.